J1265
HCPCS Procedure Code
HCPCS code J1265 is the #8,552 most-billed Medicaid procedure code, with $2K in payments across 840 claims from 2018–2024. The national median cost per claim is $2.67.
Total Paid
$2K
0.00% of all spending
Total Claims
840
Providers
1
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J1265? Based on 1 providers billing this code nationally.
Median
$2.67
Average
$2.67
Std Dev
—
Max
$2.67
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.67 and $2.67 per claim for this code.
90% bill between $2.67 and $2.67.
Top 1% bill above $2.67.
About This Procedure
HCPCS code J1265 was billed by 1 providers across 840 claims, totaling $2K in Medicaid payments from 2018–2024. This code was used for 658 unique beneficiaries.
Fraud Risk Context
Injectable drug codes carry high per-claim costs and have been involved in drug diversion and upcoding schemes.
Source: HHS OIG Reports
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.67
Providers Billing
1
National Spending
$2K
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.